| Literature DB >> 33953896 |
Ruxian Huang1, Yan Jiang1, Xiaoyun Le1.
Abstract
Malignant tumors of digestive system mainly include gastric cancer, colorectal cancer, and esophageal cancer, which generally need chemotherapy. PICC refers to peripherally inserted central venous catheter, which plays an important role in the treatment of malignant tumor patients with chemotherapy, and it has the characteristics of high success rate of puncture and reducing the pain of patients. Its principle is to use PICC catheter for drug delivery, which can effectively reduce the pain of tumor patients for multiple puncture, and also can avoid drug extravasation or local stimulation of drugs. However, PICC catheter-related complications cannot be ignored, to some extent, directly affect the treatment effect of patients, and increase the pain and burden of patients. Therefore, this paper proposes a study of PICC catheter-related complications and protective nursing for patients with digestive system cancer based on smart medical block chain. First of all, using the method of literature, this paper deeply studied the combination of smart medicine and block chain and further strengthened the research on PICC catheter-related complications. Based on this, we designed a study on the prevention and nursing of PICC catheter-related complications in patients with digestive system cancer. Before the implementation of nursing, the incidence of complications in patients with digestive system cancer was 17.35%; after the implementation of nursing, the incidence of complications decreased to 4.08%. The purpose of this study is to analyze the causes through clinical research and put forward the protective nursing measures of related diseases, so as to reduce the incidence of PICC-related complications.Entities:
Mesh:
Year: 2021 PMID: 33953896 PMCID: PMC8057877 DOI: 10.1155/2021/5519722
Source DB: PubMed Journal: J Healthc Eng ISSN: 2040-2295 Impact factor: 2.682
Figure 1Adaptability and advantages of PICC tube.
Figure 2The technology roadmap of the experimental research in this paper.
Factors and evaluation of complications related to PICC catheter.
| Project | Code | Assignment |
|---|---|---|
| Gender | X1 | 1 = male, 2 = female |
| Age | X2 | 1 = under 40 years old, 2 = 40–59 years old, 3 = 60 years old and above |
| Height | X3 | 1 = below 160 cm, 2 = 161–170 cm, 3 = 171–180 cm, 4 = above 181 |
| Weight | X4 | 1 = below 40 kg, 2 = 41–50 kg, 3 = 51–60 kg, 4 = above 60 kg |
| Smoking | X5 | 1 = yes, 2 = no |
| Drink | X6 | 1 = yes, 2 = no |
| History of drug allergy | X7 | 1 = yes, 2 = no |
| History of diabetes | X8 | 1 = yes, 2 = no |
| Tumor types | X9 | 1 = gastric cancer, 2 = colorectal cancer, 3 = esophageal cancer |
| Times of chemotherapy | X10 | 1 = 1–6 times, 2 = more than 6 times |
| PICC catheter site | X11 | 1 = basilic vein, 2 = median cubital vein, 3 = cephalic vein |
| Catheter factors | X12 | 1 = catheter size, 2 = catheter model, 3 = catheter cavity number |
| Catheterization technology | X13 | 1 = direct puncture, 2 = Seldinger technique |
| Puncture times | X14 | 1 = more than 2 times, 2 = 1 success |
| Position of catheter tip | X15 | 1 = too deep, 2 = too shallow, 3 = level 6, 7 thoracic vertebrae |
| Maintenance mode | X16 | 1 = out of hospital maintenance, 2 = inhospital maintenance |
| Maintenance cycle | X17 | 1 = less than or equal to 7 d, 2 = more than 7 d |
Logistic regression analysis of PICC catheter-related complications in patients with digestive system malignant tumor undergoing chemotherapy.
| Project |
| SE value | Wald x2 value |
| OR (95%CI) |
|---|---|---|---|---|---|
| Gender | 1.029 | 0.422 | 4.218 | <0.05 | 1.318 |
| Age | 1.388 | 1.225 | 0.664 | >0.05 | 4.035 |
| Height | 1.268 | 1.527 | 0.904 | >0.05 | 4.334 |
| Weight | 1.179 | 1.423 | 0.734 | >0.05 | 3.856 |
| Smoking | 1.059 | 1.228 | 0.537 | >0.05 | 4.736 |
| Drink | 1.468 | 1.628 | 0.883 | >0.05 | 3.696 |
| History of drug allergy | 1.358 | 0.232 | 6.298 | <0.05 | 1.438 |
| History of diabetes | 1.138 | 0.322 | 4.789 | <0.05 | 1.228 |
| Tumor types | 1.158 | 1.236 | 0.628 | >0.05 | 1.438 |
| Times of chemotherapy | 1.356 | 1.124 | 0.765 | >0.05 | 20.33 |
| PICC catheter site | 1.337 | 1.459 | 0.867 | >0.05 | 3.433 |
| Catheter factors | 1.118 | 0.292 | 6.627 | >0.05 | 2.456 |
| Catheterization technology | 1.389 | 1.358 | 0.984 | >0.05 | 3.537 |
| Puncture times | 1.015 | 0.292 | 7.425 | <0.05 | 2.666 |
| Position of catheter tip | 1.228 | 0.282 | 6.645 | <0.05 | 3.458 |
| Maintenance mode | 1.129 | 0.845 | 4.817 | <0.05 | 3.128 |
| Maintenance cycle | 1.239 | 0.572 | 5.598 | <0.05 | 2.429 |
Figure 3Logistic regression analysis of PICC catheter-related complications in patients with digestive system malignant tumor undergoing chemotherapy.
Types of PICC-related complications during chemotherapy.
| Types of PICC-related complications | Number of cases | Percentage (%) |
|---|---|---|
| Bleeding at puncture site | 17 | 5.43 |
| Phlebitis | 13 | 4.22 |
| Catheter blockage | 9 | 3.31 |
| Allergic changes of skin | 9 | 2.92 |
| Thrombosis | 6 | 1.86 |
| Total | 54 | 17.35 |
Figure 4Types of PICC-related complications during chemotherapy.
Cox regression model analysis of common complications of PICC in patients with malignant tumor during chemotherapy.
| Project | B | SE | Wald | P | HR | 95.0% CI for HR | |
|---|---|---|---|---|---|---|---|
| Lower part | Upper part | ||||||
| History of diabetes | 0.482 | 0.225 | 5.027 | 0.025 | 1.619 | 1.063 | 2.467 |
| Maintenance mode | −0.643 | 0.212 | 8.423 | 0.004 | 0.536 | 0.342 | 0.822 |
| Maintenance cycle | 0.481 | 0.232 | 4.282 | 0.039 | 1.616 | 1.035 | 2.548 |
Single factor analysis of catheter prolapse.
| Influence factor | Variable | Number of respondents | Catheter prolapse group (cases/%) | Noncatheter prolapse group (cases/%) | X2 value |
|
|---|---|---|---|---|---|---|
| Catheter model | 4F | 379 | 32 (8.44) | 347 (91.56) | 0.359 | 0.654 |
| 5F | 78 | 5 (6.41) | 73 (93.59) | |||
|
| ||||||
| Number of lumens | Single chamber | 387 | 32 (8.27) | 355 (91.73) | 0.101 | 0.819 |
| Double cavity | 70 | 5 (7.14) | 65 (92.86) | |||
|
| ||||||
| Catheterization technology | Direct puncture | 39 | 2 (5.13) | 37 (94.87) | 0.163 | 0.687 |
| seldinger | 418 | 35 (8.37) | 383 (91.63) | |||
|
| ||||||
| Puncture times | Once | 382 | 31 (8.12) | 351 (91.88) | 0.001 | 1.000 |
| Greater than or equal to twice | 75 | 6 (8) | 69 (92) | |||
|
| ||||||
| Venipuncture | Basilic vein | 399 | 31 (7.77) | 368 (92.23) | 1.464 | 0.555 |
| Median cubital | 39 | 5 (12.85) | 34 (87.18) | |||
| Cephalic vein | 19 | 1 (5.26) | 18 (94.74) | |||
Figure 5Single factor analysis of catheter prolapse.
Comparison of the knowledge and compliance scores of PICC in two groups.
| Group | Number of cases | Mastery of PICC knowledge | Catheter compliance score |
|---|---|---|---|
| Control group | 45 | 85.45±2.11 | 82.04±3.13 |
| Experience group | 45 | 95.24±3.24 | 96.34±3.28 |
| t | — | 8.222 | 9.121 |
| P | — |
|
|
Figure 6Comparison of the knowledge and compliance scores of PICC in two groups.
Comparison of nursing service satisfaction between two groups of patients with PICC in tumor chemotherapy.
| Group | Number of cases | Satisfied | Quite satisfied | Dissatisfied | Satisfaction |
|---|---|---|---|---|---|
| Control group | 45 | 21 | 15 | 9 | 36 (80.00) |
| Experience group | 45 | 36 | 9 | 0 | 45 (100.00) |
| X2 | — | — | — | — | 10.00 |
| P | — | — | — | — | 0.0016 |
Figure 7Comparison of nursing service satisfaction between two groups of patients with PICC in tumor chemotherapy.